Age-specific effectiveness of a tuberculosis screening intervention in children.

Autor: Brooks MB; Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America., Dubois MM; Division of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, United States of America.; Harvard Medical School, Boston, Massachusetts, United States of America., Malik AA; Yale Institute for Global Health, New Haven, Connecticut, United States of America.; Interactive Research and Development Global, Singapore, Singapore., Ahmed JF; The Indus Hospital and Health Network, Korangi Crossing, Karachi, Pakistan., Siddiqui S; The Indus Hospital and Health Network, Korangi Crossing, Karachi, Pakistan., Khan S; Sayed Abdullah Shah Institute of Medical Sciences Sehwan, Sehwan, Pakistan., Brohi M; Communicable Diseases Control, Department of Health, Sindh, Hyderabad, Pakistan., Das Valecha T; Sayed Abdullah Shah Institute of Medical Sciences Sehwan, Sehwan, Pakistan., Amanullah F; The Indus Hospital and Health Network, Korangi Crossing, Karachi, Pakistan., Becerra MC; Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America., Hussain H; Interactive Research and Development Global, Singapore, Singapore.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Feb 18; Vol. 17 (2), pp. e0264216. Date of Electronic Publication: 2022 Feb 18 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0264216
Abstrakt: Objective: To apply a cascade-of-care framework to evaluate the effectiveness-by age of the child-of an intensified tuberculosis patient-finding intervention.
Design: From a prospective screening program at four hospitals in Pakistan (2014-2016) we constructed a care cascade comprising six steps: screened, positive screen, evaluated, diagnosed, started treatment, and successful outcome. We evaluated the cascade by each year of age from 0 to 14 and report the age-specific mean proportion and standard deviation.
Results: On average across all ages, only 12.5% (standard deviation: 2.0%) of children with a positive screen were not evaluated. Among children who had a complete evaluation, the highest percentages of children diagnosed with tuberculosis were observed in children 0-4 (mean: 31.9%; standard deviation: 4.8%), followed by lower percentages in children 5-9 (mean: 22.4%; standard deviation: 2.2%), and 10-14 (mean: 26.0%; standard deviation:5.4%). Nearly all children diagnosed with tuberculosis initiated treatment, and an average of 93.3% (standard deviation: 3.3%) across all ages had successful treatment outcomes.
Conclusions: This intervention was highly effective across ages 0-14 years. Our study illustrates the utility of applying operational analyses of age-stratified cascades to identify age-specific gaps in pediatric tuberculosis care that can guide future, novel interventions to close these gaps.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje